PRESUMED SYSTEMIC BACILLE CALMETTE-GUÉRIN DISEASE AFTER BCG VACCINATION: REPORT OF A CLINICAL CASE (original) (raw)
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Disseminated Bacillus CalmetteGuerin Infection after BCG Vaccination
Journal of Tropical Pediatrics
The BCG is administered to all the newborns at birth in Iran. Systemic adverse reactions to BCG vaccine such as osteomyelitis and disseminated BCG infection are rare. This is a retrospective study of 15 cases _72 months who were admitted with systemic syndrome compatible with disseminated mycobacterial disease during 2004-07. Disseminated BCG disease occurred in eight children younger than 6-months old and 12 patient younger than 12-months old. Twelve patients were male. Nine of 15 patients had well known primary immune deficiency disorders including severe combined immunodeficiency, chronic granulomatous disease; cell mediated immune defect and HIV infection. Nine (60%) cases had good response to four anti-mycobacterial drug therapy and interferon gamma. Disseminated BCG disease is a rare but devastating complication of BCG vaccination that should be considered in the appropriate clinical setting. Severe immune-compromised infants are at greatest risk and they respond poorly to standard therapies.
Vaccine, 2018
Background: Bacille Calmette-Guérin (BCG) vaccination at birth may cause mild and benign local adverse effects (AE). More serious AE are rarely reported. Objective: To describe clinical features and outcomes of BCG (Tokyo-172 strain)-induce diseases (BCG-ID) that required medical attention at a tertiary care center in Bangkok, Thailand. Method: We retrospectively reviewed medical records from January 2007 to December 2016 that were selected by ICD-10 codes. The inclusion criteria were the patients under 3 years of age who developed lymphadenitis, osteitis, or disseminated infections of which BCG was a possible pathogen. Cases were classified into suspected (clinically compatible without laboratory confirmation), probable (suspected cases with M. tuberculosis complex identified), and confirmed BCG-ID (probable cases with molecular confirmation of M. bovis BCG strain). Results: 95 children were identified; 57 (60.0%) were male, and the median age at presenting symptom was 3.5 (range: 0.6-28.7) months. Of these, 25 (26.3%) were suspected, 49 (51.6%) were probable, and 21 (22.1%) were confirmed BCG-ID. Overall, 87 (92%) children had regional lymphadenitis corresponding to the BCG site, 5 (5%) had osteitis, and 3 (3%) had disseminated BCG. Of those with lymphadenitis, average size was 2.2 (range 0.7-5) cm. in diameter and 53% (46/87) had pulmonary involvement. Five children with immunodeficiency; three had disseminated BCG and two had lymphadenitis. Eight (9.2%) patients with lymphadenitis underwent needle aspiration; 57 (65.5%) had surgical excision. All children with BCG osteitis underwent surgical intervention in combination with anti-tuberculosis treatment. One patient with osteitis experienced long-term leg length discrepancy. Conclusion: Regional lymphadenitis was the most common feature of BCG-ID requiring medical attention. That none of the BCG osteitis were immunocompromised hosts suggested the potential virulence of BCG in neonates. A systematic national surveillance and reporting system is needed to develop accurate estimates of population incidence and support development of effective vaccine policy.
Allergologia et Immunopathologia, 2020
Background: Bacille Calmette-Guerin (BCG) vaccination has a great impact on the prevention of severe complications of tuberculosis. However, in patients with primary immunodeficiencies (PID), it can lead to severe complications such as severe combined immunodeficiency, chronic granulomatous disease, and Mendelian susceptibility to mycobacterial disease. This study highlights the demographics, clinical complications and laboratory parameters among PID patients associated with BCG vaccination side effects.
Disseminated Bacille Calmette-Guérin Infection at a Glance: A Mini Review of the Literature
Advances in respiratory medicine, 2019
Introduction: Immunodeficient children are at a high risk of disseminated Bacillus Calmette-Guérin [BCG] infection. We assessed the literature on clinical manifestations of BCGosis in children with specific primary immunodeficiencies. Material and methods: We conducted a systematic review of clinical practice articles by searching Medline, PubMed, Embase, Scopus, Web of Science and Google Scholar from their inception to date. Results: Thirty-seven articles were included regarding BCG vaccination and its dissemination in children with primary immunodeficiencies. Articles on dissemination after intravesicular BCG were excluded from the study. Conclusions: Since disseminated BCG vaccination may be the first manifestation of a primary immunodeficiency disease, a comprehensive search for immunological defects in children developing these problems after BCG vaccination seems rational.
Journal of the College of Physicians and Surgeons Pakistan Jcpsp, 2014
Bacille Calmette-Guerin (BCG) vaccine is administered to all newborns in countries where tuberculosis is still endemic. It is a live attenuated vaccine and considered quite safe in immunocompetent children. Disseminated BCG disease is the most serious complication seen only in individuals with underlying primary or secondary immunodeficiencies. We report a case of disseminated BCG disease in an infant with Severe Combined Immunodeficiency (SCID) who received BCG administration prior to diagnosis of SCID.
Severe disseminated BCG infection in an 8-year-old girl
Nagoya journal of medical science, 2000
An 8-year-old girl died of sepsis due to staphylococcal infection one year and 8 months after Bacille Calmette-Guerin (BCG) revaccination. Two months after the vaccination in accordance with the school health program, she was hospitalized with a high fever, skin rash over the face and lower limbs, and leukopenia. Her clinical and laboratory pictures were not compatible with those of any established type of immunodeficiency. The polymerase chain reaction (PCR) test for M. tuberculosis complex was positive for bone marrow, pleural fluid, and peripheral blood. The strain recovered from a mycobacterial culture of the blood was identical to the BCG strains with which the patient was vaccinated, based on restriction fragment length polymorphism (RFLP) and a pulse-field gel electrophoresis (PFGE) analyses of DNA. She developed finally a lung abscess due to staphylococcal septicemia, which was the direct cause of her death.